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Biomedical subjects

G Schlaf

Publications and source records attributed to G Schlaf.

24 records · Page 2Linked to original sources

[Sleep complaints and hypnotic use by the elderly--results of a representative survey in West Germany].

For the first time, a country-wide group of West-Germans were interviewed regarding their sleep complaints and hypnotic intake. Therefore 344 persons who were older than 65 years and 1653 subjects between the age of 14 and 65 years were representatively selected by a random route system. Around the age of 45 the prevalence of sleep-disturbances starts rising continuously and dramatically. Over the age of 65 nearly half of the West-Germans (43%) suffer from difficulties in initiating and/or maintaining sleep (DIMS) at least sometimes, 15% suffer frequently or always from these complaints. 79% of the sleep disturbed elderly (over the age of 65) are chronically ill, having sleep-complaints for more than 2 years or since childhood. The hypnotika intake increases with age as well. Around 45 years of age the irregular hypnotika intake (several times the year or month), and after 55 years of age, regular hypnotic intake (daily or several times the week) rapidly rises. After 65 years of age hypnotic intake increases much more than the sleep complaints do. So, every third elderly person (34%) takes hypnotics at least irregularly. The results of this study indicate that sleep complaints in the elderly are three times more common and more severe than in younger persons, and that they tend to chronify while treated with hypnotics.

Adolescent↗

Origin and immunoregulation of autoantibodies against intestinal alkaline phosphatase.

In the sera of patients with acute bacterial infections specific autoantibodies (sIAPa) of the immunoglobulin class G (IgG) were found which bind to intestinal alkaline phosphatase (IAP) through the Fab portion. This was demonstrated using immunoaffinity (IA) isolation of sIAPa from patients' sera (particularly bacterial meningitis and ventriculitis) digestion with pepsin, purification of F(ab')2 fragments on protein A and subsequently binding on IAP coupled to CNBr (cyanogen bromide)-activated Sepharose. Immunoblots using specific anti-Fc and anti-Fab antibodies showed that the bulk of F(ab')2 fragments had bound. Additionally, binding of native IAP to the F(ab')2 fragments was observed after separation of F(ab')2 fragments using isoelectric focusing (IEF), blotting onto nitrocellulose and incubation with IAP. Moreover, we have demonstrated the occurrence of natural anti-IAP autoantibodies (nIAPa) which were isolated from sera of healthy individuals using IA chromatography. Investigation of isotype distribution revealed that IgG but not IgM or IgA were predominant even among nIAPa. The nIAPa fraction exhibited lower binding efficiencies on IEF blots than the sIAPa fraction, however, in contrast to sIAPa, cross-reactions with other autoantigens were observed for nIAPa. NIAPa and sIAPa did not show subclass restriction. As revealed by IEF the spectrotypes of sIAPa were found to be patient-specific, poly- to oligoclonal and stable during longer periods.

Acute Disease↗

[Chronification of sleep disorders. Results of a representative survey in West Germany].

In a representative selection of German citizens who were older than 13 years of age, 1,997 were asked about their sleep complaints. They were also asked how frequently a physician was consulted and how often sleeping pills were taken. According to our results sleep disturbances are an important health problem in Germany. Every fourth person suffers at least sometimes from difficulties in falling asleep and/or staying asleep, problems which are not due to external influences. Seven percent suffer frequently or always from these complaints; 15% report that they are frequently tired or that they are always tired during the day. Ten percent of all persons suffering from sleep complaints take sleeping pills daily or at least sometimes during the week. Forty-five percent of all persons who take hypnotics daily still frequently or always suffer from difficulties in falling asleep and/or staying asleep. Furthermore, sleep complaints tend to become chronic: 75% of the sleep-disturbed population are chronically ill, having had complaints for more than 2 years of since childhood. They suffer from sleep disturbances and from reduced performance during the following day. Nevertheless, it appears as though neither patients nor physicians take insomnia seriously. This might answer the question of why only 17% of the persons who do not suffer more than 2 years from sleep disturbances and only 49% of the chronically ill population consult a doctor because of their sleep disturbances. The results of this study indicate the importance of informing patients and physicians about insomnia and different ways of treating it.

Adolescent↗

Survival in multiple sclerosis.

Survival from onset of symptoms was calculated for two series of MS patients, a population-based epidemiologic series from southern Lower Saxony of 224 cases, and a revised hospital series of 1429 cases from 11 neurologic centers throughout the Federal Republic of Germany. Median survival for the epidemiologic series was 35-42 years, with no finer estimate possible. Observed survival was 3/5 expected survival after 35 years of illness. Survival in this series was similar to that from two other population-based reports. No significant difference was found between the sexes, though patients with onset at age 35 + had a significantly shorter survival than those with onset at age under 35 years. The much larger hospital series, where median survival was 30 years, demonstrated significant differences separately favoring females and young onsets. However, the ratios of observed to expected survival from population life tables were strikingly similar among all four subgroups defined by sex and age at onset. While overall there is a substantial reduction in the expectation of life in MS, the differential survival by sex and age appears to be a reflection of the expected survival by sex and age per se, and not that of the disease.

Adult↗

Prognostic indicators in multiple sclerosis.

The influence of sex, age at onset, course of the disease and initial symptomatology on the mortality of patients with multiple sclerosis is analysed. A sample of 1926 patients was followed up prospectively over 4.9 years. Both, the mortality ratio (number of observed to expected deaths) and the excess death rate are calculated. Whereas the mortality ratio as a parameter of overall mortality is influenced by a variety of factors, such as age and sex; the excess death rate represents the number of extra deaths per 1000 exposed to risk in an indicated year and is, therefore, a parameter of the mortality which is attributed to MS. The excess death rate was comparable for the sexes, it was slightly higher for patients with a higher age at onset and it was clearly higher for the progressive course. Patients with initial diplopia and sensory signs and symptoms had the lowest excess death rate, whereas patients with pareses, cerebral and sphincter disturbances at onset showed the highest excess death rate.

Adult↗